I have been examining this phenomenon closely in patient 2H-A for days now, and while it is tempting to express confidence in my having come to a place where I understand this aspect of the delusion more greatly, I’m afraid to say that I am no better off now than I was at the start. Maybe I need to crack open the older luminaries afresh, poke my head around in the works of Freud or Nietzsche, for example, and gain understanding. I really do feel like a sophomore at times.
It is the patient’s fervency that so confounds me. I know such impulses run as deep as her skin, and that her actions are anchored in an ocean of habits- many of which have been reinforced through steady repetition- but there is something startling, something unbalancing to me about her prayer life. She prays with such conviction- such assurance- as if there is really someone in the room.
I suppose I do talk to myself at times. Perhaps it is here where some measure of insight can be gained into her psychosis- where I can dip the tip of my toe in, so to speak. But whatever and to what degree the semblance, I cannot imagine talking to a unicorn. It defies understanding. And this marks the crucial difference. But in an effort to crawl inside her mind, I have tried to think what it must be like to speak to an invisible being.
I have observed that she often closes her eyes while praying. Is that a matter of tradition- simply a show of respect- or does she do this so as to escape the absurdity of the situation? It would be hard to talk to a couch, after all. I ask because might it prove beneficial to require her to pray with her eyes open? It’s such an elementary suggestion, and one I’m almost embarrassed to suggest, but could it prove useful? Surely others have tried, yes? Here I recall Dr. Dennett once sharing how there appeared to be a direct link between the prayer life of a patient and their eventual salvation. In the case of those who were not given to much prayer- only bending their knees occasionally- the success rate nearly tripled. It is true that for some the circumstances of the Institute served to embolden their prayer life, fanning the delusion into flame, as it were, but on the whole he urged that lack of prayer is a sure signal of budding health. It makes sense.
Forgive me. I’m digressing. Let me get to the point.
After several days of carefully cataloging the substance of her prayers (and here I should express a particular appreciation of the forms issued by the Institute. They are surprisingly helpful), a number of peculiar and consistent traits have emerged. Here are a few of the more salient features (I’m leaving out the more obvious traits like offering up thanksgiving or praise):
- An express trust in her delusions’ sovereignty (She appears to believe that God is in complete control of everything, even something as seemingly incidental as a sparrow falling to the ground [As an aside, this might be a point to explore with her when we enter stage 2. I can see all kinds of inconsistencies with such a view!]).
- Confession (Of various character flaws. Though of considerable importance is her asking forgiveness for unbelief. See below for more)
- Intercession for others (Here I should add that she is careful not to divulge specific names... save myself and a few others at the Institute)
- Petitions for wisdom
- Petitions for improvements of character (especially love)
- Petitions for faithfulness
- Indirect imprecation (Her delusion harbors classic “Judgment Day” theology)
- Doctrinal curiosities like praying at times to “The Father,” or “The Son,” or “The Holy Spirit,” or just “Spirit.”
There is another curiosity about prayer that confounds me, and maybe it is peculiar to this patient. She doesn’t always pray out loud, so it is somewhat challenging to acquire a baseline, but sometimes when she does there is an odd admixture of faith and doubt expressed. The first time I observed the phenomenon it was late at night. Rising from her bed, she suddenly began pacing about the room. She looked troubled. A moment later, she began to cry. This carried on for some time, until at last she fell alongside her bed and eventually into prayer. The words are recorded, so there is no mistaking the matter. Through tearful sobs, she said, and I quote,
“Will the Lord reject forever? Will he never show his favor again? Has his unfailing love vanished forever? Has his promise failed for all time?”
Isn’t that fascinating? Questions of doubt are budding. It’s right there in black and white. And yet, almost as if amnesia suddenly set it, she forgot what she had just said (as if the meme reasserted itself in the face of potential extinction). After mumbling a few words under her breath, the following came out clearly, “Your ways, O God, are holy. What god is so great as our God?”
Even though she ended in praise, I’m encouraged. There is a glimmer of hope- real advancement, even if slight and momentary. The strategy now is clear: get her to place a firm period after those expressions of doubt. I have some ideas.
Lastly, I would like to learn more about the objects of her prayer. There appears to be something of a tri-personage to her delusion (as I mentioned briefly above): a father aspect, a son aspect, and some other spiritual component. Once she merely said, “Spirit.” Is that a title or an attribute? I spoke briefly with Jamison, another student in residency, and he seemed to think this was all Trinitarian in nature, a vestige of the past. An ancient city now comes to my mind. Nicaea, I believe. Wasn’t a creed fashioned there, or some other such document of Christian repute? Forgive me, my memory is failing me.
Actually, I have been meaning to look into Christian doctrine more fully- even, if the chancellor would grant permission, the Christian texts themselves. I am well aware that such writings are under lock and key, so to speak, and that several recommendations would be needed before I could gain access, but I do feel this could prove to be an invaluable aid. Further study- more detailed study- would sharpen my skills.
Is it too early to begin pursuing such an endeavor?
I do hasten to add, however, that there is much wisdom to the Institute’s safeguards. Whatever you, or they, think best, to this I will gladly submit. Folie à deux is always to be taken seriously. Even innocuous transmissions are dangerous.
It is interesting to think that at some glorious point in the future, when all such viruses have been eradicated from the social structure, that we will be the final carriers of the religious meme, and therefore the ones to hammer the last nail in the coffin.